Mindfulness meditation and improvement in depressive symptoms among Spanish- and English speaking adults: A randomized, controlled, comparative efficacy trial

Eric Lopez-Maya, Richard Olmstead, Michael R Irwin, Eric Lopez-Maya, Richard Olmstead, Michael R Irwin

Abstract

Objective: Latino immigrants experience acculturative stress and increased depression risk. Mindfulness meditation improves depressive symptoms, yet the vast majority of research has focused on English speaking populations.

Methods: In this randomized clinical trial with 2 parallel treatment groups, adults with moderate levels of perceived stress (n = 76) were recruited from the Los Angeles community from October 2015 to March 2016, stratified into Spanish- (n = 36) and English speaking (n = 40) language groups, and randomized for 6 weeks of treatment with standardized mindful awareness practices (MAPs) or health education (HE). Main outcome measure was depressive symptoms, measured by the Beck Depression Inventory.

Results: Using an intent-to-treat analysis, the primary outcome, depressive symptoms as indexed by the Beck Depression Inventory, showed greater improvement in MAPs vs. HE, with a between-group post-intervention mean difference of -2.2 (95% CI -4.4 - -0.07) and effect size of 0.28; similar effect sizes were found in the the Spanish- (0.29) and English speaking (0.30) groups. MAPs showed significant improvement relative to HE on secondary outcome of mindfulness with between group difference of 10.7 (95% CI4.5-16.9), but not perceived stress.

Conclusion: The comparable efficacy of Spanish and English formats of mindfulness meditation in improving depressive symptoms suggests that this community based intervention may mitigate depression risk in Latino adults who are experiencing social adversity.

Trial registration: ClinicalTrials.gov NCT03545074.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Consolidated standards of reporting trials…
Fig 1. Consolidated standards of reporting trials flow diagram of the single-site, parallel-group randomized clinical trial of MAPs compared with HE for depressive symptoms in English- and Spanish speaking adults.

References

    1. Slavich G. M. & Irwin M. R. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychol Bull 140, 774–815, 10.1037/a0035302 (2014).
    1. Kendler K. S., Kessler R. C., Walters E. E., MacLean C., Neale M. C., Heath A. C., et al. Stressful life events, genetic liability, and onset of an episode of Major Depression in women. Am J Psychiatry 152, 833–842 (1995). 10.1176/ajp.152.6.833
    1. Mazure C. M. Life stressors as risk factors in depression. Clinical Psychology: Science and Practice 5, 291–313 (1998).
    1. Berry, J. W. in Handbook of multicultural perspectives on stress and coping 287–298 (Spring, 2006).
    1. Romero, A. & Pina-Watson, B. in The Oxford Handbook of Acculturation and Health 119–130. (Oxford, 2017).
    1. Nair R. L., Roche K. M. & White R. M. B. Acculturation Gap Distress among Latino Youth: Prospective Links to Family Processes and Youth Depressive Symptoms, Alcohol Use, and Academic Performance. J Youth Adolesc 47, 105–120, 10.1007/s10964-017-0753-x (2018).
    1. Cobb C. L., Xie D., Meca A. & Schwartz S. J. Acculturation, discrimination, and depression among unauthorized Latinos/as in the United States. Cultur Divers Ethnic Minor Psychol 23, 258–268, 10.1037/cdp0000118 (2017).
    1. Lorenzo-Blanco E. I., Unger J. B., Baezconde-Garbanati L., Ritt-Olson A. & Soto D. Acculturation, enculturation, and symptoms of depression in Hispanic youth: the roles of gender, Hispanic cultural values, and family functioning. J Youth Adolesc 41, 1350–1365, 10.1007/s10964-012-9774-7 (2012).
    1. Farley T., Galves A., Dickinson L. M. & Perez Mde J. Stress, coping, and health: a comparison of Mexican immigrants, Mexican-Americans, and non-Hispanic whites. J Immigr Health 7, 213–220, 10.1007/s10903-005-3678-5 (2005).
    1. Goyal M., Singh S., Sibinga E. M., Gould N. F., Rowland-Seymour A., Sharma R., et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med 174, 357–368, 10.1001/jamainternmed.2013.13018 (2014).
    1. Black D. S., O'Reilly G. A., Olmstead R., Breen E. C. & Irwin M. R. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med 175, 494–501, 10.1001/jamainternmed.2014.8081 (2015).
    1. Brown K. W. & Ryan R. M. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 84, 822–848 (2003).
    1. Garcia-Campayo J, Demarzo M, Shonin E, Van Gordon W. How do cultural factors influence the teaching and practice of mindfulness and compassion in Latin countries? Frontiers in Psychology. 2017.
    1. Proulx J., Croff R., Oken B., Aldwin C. M., Fleming C., Bergen-Cico D., et al. Considerations for Research and Development of Culturally Relevant Mindfulness Interventions in American Minority Communities. Mindfulness (N Y) 9, 361370, 10.1007/s12671-017-0785-z (2018).
    1. Cohen S., Kamarck T. & Mermelstein R. A global measure of perceived stress. J Health Soc Behav 24, 385–396 (1983).
    1. Raison C. L., Rutherford R. E., Woolwine B. J., Shuo C., Schettler P., Drake D. F., et al. A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression: the role of baseline inflammatory biomarkers. JAMA Psychiatry 70, 31–41, 10.1001/2013.jamapsychiatry.4 (2013).
    1. Miller A. H. & Raison C. L. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol 16, 22–34, 10.1038/nri.2015.5 (2016).
    1. Smalley S. L. & Winston D. Fully Present: The Science, Art, and Practice of Mindfulness. (Da Capo Press, 2010).
    1. Irwin M. R., Olmstead R., Carrillo C., Sadeghi N., Breen E. C., Witarama T., Yokomizo M., Lavretsky H., Carroll J. E., et al. Cognitive behavioral therapy vs. Tai Chi for late life insomnia and inflammatory risk: a randomized controlled comparative efficacy trial. Sleep 37, 1543–1552, 10.5665/sleep.4008 (2014).
    1. Beck A. T., Steer R. A. & Garbin M. G. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev 8, 77–100 (1988).
    1. Brown C., Schulberg H. C. & Madonia M. J. Assessing depression in primary care practice with the Beck Depression Inventory and the Hamilton Rating Scale for Depression. Psychol Assess 7, 59–65 (1995).
    1. Bumberry W., Oliver J. M. & McClure J. N. Validation of the Beck Depression Inventory in a university population using psychiatric estimate as the criterion. J Consult Clin Psycho l 46, 150–155 (1978).
    1. Azocar F., Arean P., Miranda J. & Munoz R. F. Differential item functioning in a Spanish translation of the Beck Depression Inventory. J Clin Psychol 57, 355–365. (2001).
    1. Bohlmeijer E., ten Klooster P. M., Fledderus M., Veehof M. & Baer R. Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment 18, 308–320, 10.1177/1073191111408231 (2011).
    1. Steiger J. H. (2004). Beyond the F test: Effect size confidence intervals and tests of close fit in the analysis of variance and contrast analysis. Psychological Methods, 9, 164–182 10.1037/1082-989X.9.2.164
    1. Alegria M., Mulvaney-Day N., Torres M., Polo A., Cao Z. & Canino G. Prevalence of psychiatric disorders across Latino subgroups in the United States. Am J Public Health 97, 68–75, 10.2105/AJPH.2006.087205 (2007).
    1. Fournier J. C., DeRubeis R. J., Hollon S. D., Dimidjian S., Amsterdam J. D., Shelton, et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 303, 47–53, 10.1001/jama.2009.1943 (2010).
    1. Ryan D., Maurer S., Lengua L., Duran B. & Ornelas I. J. Amigas Latinas Motivando el Alma (ALMA): an Evaluation of a Mindfulness Intervention to Promote Mental Health among Latina Immigrant Mothers. J Behav Health Serv Res 45, 280–291, 10.1007/s11414-017-9582-7 (2018).
    1. Manotas M., Segura C., Eraso M., Oggins J. & McGovern K. Association of Brief Mindfulness Training With Reductions in Perceived Stress and Distress in Colombian Health Care Professionals. Int J Stress Manage 21, 207–225, 10.1037/a0035150 (2014).
    1. Irwin M. R., Olmstead R., Carrillo C., Sadeghi N., Nicassio P., Ganz P. A., et al. E. Tai Chi Chih compared with cognitive behavioral therapy for the treatment of insomnia in survivors of breast cancer: a randomized, partially blinded, noninferiority trial. J Clin Oncol 35, 2656–2665, 10.1200/JCO.2016.71.0285 (2017).
    1. Bower J. E. & Irwin M. R. Mind-body therapies and control of inflammatory biology: A descriptive review. Brain Behav Immun 51, 1–11, 10.1016/j.bbi.2015.06.012 (2016).
    1. Bower J. E., Crosswell A. D., Stanton A. L., Crespi C. M., Winston D., Arevalo J., et al. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer 121, 1231–1240, 10.1002/cncr.29194 (2015).
    1. Irwin M., Olmstead R., Breen E., Witarama T., Carrillo C., N S., Arevalo J., et al. Tai Chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial J Natl Cancer Inst 50, 295–301 (2014).
    1. Bower J. E., Greendale G., Crosswell A. D., Garet D., Sternlieb B., Ganz P. A., et al. W. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: a randomized controlled trial. Psychoneuroendocrinology 43, 20–29, 10.1016/j.psyneuen.2014.01.019 (2014).
    1. Kennedy B. K., Berger S. L., Brunet A., Campisi J., Cuervo A. M., Epel E. S., et al. Geroscience: linking aging to chronic disease. Cell 159, 709–713, 10.1016/j.cell.2014.10.039 (2014).
    1. Franceschi C. & Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci 69 Suppl 1, S4–9, 10.1093/gerona/glu057 (2014).
    1. Campisi J. Aging, cellular senescence, and cancer. Annu Rev Physiol 75, 685–705, 10.1146/annurev-physiol-030212-183653 (2013).
    1. Irwin M. R. & Cole S. W. Reciprocal regulation of the neural and innate immune systems. Nature Rev Immunol 11, 625–632, 10.1038/nri3042 (2011).
    1. Irwin M. R., Olmstead R., Breen E. C., Witarama T., Carrillo C., Sadeghi N., et al. Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial. Biol Psychiatry 78, 721–729, 10.1016/j.biopsych.2015.01.010 (2015).
    1. Morgan N., Irwin M. R., Chung M. & Wang C. The effects of mind-body therapies on the immune system: meta-analysis. PLoS One 9, e100903, 10.1371/journal.pone.0100903 (2014).
    1. Kiecolt-Glaser J. K., Bennett J. M., Andridge R., Peng J., Shapiro C. L., Malarkey W. B., et al. Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol 32, 1040–1049, 10.1200/JCO.2013.51.8860 (2014).
    1. Fuligni A. J., Telzer E. H., Bower J., Irwin M. R., Kiang L. & Cole S. W. Daily family assistance and inflammation among adolescents from Latin American and European backgrounds. Brain, Behavior, and Immunity 23, 803–809, 10.1016/j.bbi.2009.02.021 (2009).
    1. Fuligni A. J., Telzer E. H., Bower J., Cole S. W., Kiang L. & Irwin M. R. A preliminary study of daily interpersonal stress and C-reactive protein levels among adolescents from Latin American and European backgrounds. Psychosom Med 71, 329–333, 10.1097/PSY.0b013e3181921b1f (2009).

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